Claim total
$8,576.50
base $155.66 · payer covered $8,426.50
The visit
- Class
- Ambulatory
- Code
- 424441002
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2026-03-24
- Stop
- 2026-03-24
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-9846-d0fba7bca083